Patients with neurological disorders often have lower urinary tract dysfunction, manifesting as urinary retention or urinary incontinence, and so commonly use catheters. Neurologists should therefore be aware of the different types of catheters and appliances and their risks, benefits and complications. Clean intermittent self-catheterisation is preferable to an indwelling catheter; however, if this is not possible, then a suprapubic indwelling catheter is preferable to a urethral catheter for long-term management. We review the decision-making process when selecting catheters for neurological patients, the evidence base regarding the different options and how neurologists can recognise and address complications. We also discuss alternatives to catheterisation, such as non-invasive containment products and surgical treatments, and the indications for urological referral.
- neurogenic bladder
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SM and JNP are joint senior authors.
Contributors CC—drafting the manuscript. CH, SM and JNP—drafting and editing the manuscript.
Funding JNP is supported in part by funding from the UK Department of Health NIHR Biomedical Research Centres funding scheme.
Competing interests SM has received an educational grant from Medtronic. He has no disclosures related to this work. JNP has received honoraria from Novartis, Coloplast and Wellspect. He has received royalty for book editing from Cambridge University Press. He has no disclosures related to this work. CH has received an honoraria from Coloplast and Wellspect.
Provenance and peer review Commissioned; externally reviewed by Ingrid Hoeritzauer, Edinburgh, UK.